Nursing Elites

1. A patient with bipolar disorder asks the nurse, “Why did I get this illness? I don’t want to be sick.” The nurse would best respond with:

• A. People who develop mental illnesses often had a very traumatic childhood experience.
• B. There is some evidence that contracting a virus during childhood can lead to mental disorders.
• C. Sometimes people with mental illness have an overactive immune system.
• D. We don’t fully understand the cause, but mental illnesses do seem to run in the family.

Correct answer: We don’t fully understand the cause, but mental illnesses do seem to run in the family.

Rationale: The correct response is, 'We don’t fully understand the cause, but mental illnesses do seem to run in the family.' Current research suggests that while genetics play a role in the development of mental illnesses like bipolar disorder, it is not the sole factor. Environmental influences, life experiences, and other non-genetic factors also contribute significantly to the manifestation of mental disorders. Choices A, B, and C provide incorrect information that is not supported by current research. Traumatic childhood experiences, contracting a virus during childhood, and an overactive immune system are not established causes of bipolar disorder or mental illnesses in general.

2. A physician has written an order for '2.0 mg MS q 2-4 hr prn pain.' What is the nurse's appropriate response to this order?

• A. Give 2 mg of morphine sulfate to the client
• B. Give 20 mg of morphine sulfate to the client
• C. Contact the pharmacy to clarify the order
• D. Contact the physician to rewrite the order

Correct answer: Contact the physician to rewrite the order

Rationale: The physician's order contains several errors that could lead to potential harm to the client if not addressed. The use of '2.0' involves a trailing decimal point, which may lead to confusion regarding the intended dose of the drug. Additionally, the abbreviation 'MS' is considered a Do Not Use abbreviation by the Joint Commission, as it could refer to morphine sulfate or magnesium sulfate, leading to medication errors. While the order indicates the drug should be used for pain, the nurse should contact the physician to clarify the exact dose and specific drug to be administered, ensuring safe and accurate medication administration. Therefore, the correct response is to contact the physician to rewrite the order.

3. A systemic sign of infection is ______________.

• A. swelling
• B. redness
• C. heat
• D. a lack of appetite

Correct answer: D

Rationale: The correct answer is 'a lack of appetite.' When a person experiences a systemic infection, they may exhibit signs that affect the entire body. A lack of appetite is a common systemic sign of infection, along with other symptoms like rapid pulse, fever, and an elevated white blood cell count. Swelling, redness, and heat are more indicative of localized inflammation or infection, rather than systemic involvement.

4. Asepsis is defined as ________________.

• A. the absence of all microorganisms
• B. the absence of disease-causing germs
• C. a urinary infection
• D. a pathogenic infection

Correct answer: the absence of disease-causing germs

Rationale: Asepsis is defined as the absence of disease-causing germs. It is surgical asepsis that is defined as the absence of all microorganisms, including spores. A pathogenic infection is an invasion of the body by a pathogen, or disease-causing germ, and a urinary infection is only one type of infection.

5. Employee health test results reveal a tuberculosis (TB) skin test of 16-mm induration and a negative chest x-ray for a staff nurse working on the pulmonary unit. The nurse has no symptoms of TB. Which information should the occupational health nurse plan to teach the staff nurse?

• A. Standard four-drug therapy for TB
• B. Need for annual repeat TB skin testing
• C. Use and side effects of isoniazid (INH)
• D. Bacille Calmette-Gurin (BCG) vaccine

Correct answer: Use and side effects of isoniazid (INH)

Rationale: The nurse is considered to have a latent TB infection and should be treated with INH daily for 6 to 9 months. The four-drug therapy would be appropriate if the nurse had active TB. TB skin testing is not done for individuals who have already had a positive skin test. BCG vaccine is not used in the United States for TB and would not be helpful for this individual, who already has a TB infection.

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